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VA Disability Claims: 5 Game-Changing Precedential Decisions You Need to Know
Tbird posted a record in VA Claims and Benefits Information,
These decisions have made a big impact on how VA disability claims are handled, giving veterans more chances to get benefits and clearing up important issues.
Service Connection
Frost v. Shulkin (2017)
This case established that for secondary service connection claims, the primary service-connected disability does not need to be service-connected or diagnosed at the time the secondary condition is incurred 1. This allows veterans to potentially receive secondary service connection for conditions that developed before their primary condition was officially service-connected.
Saunders v. Wilkie (2018)
The Federal Circuit ruled that pain alone, without an accompanying diagnosed condition, can constitute a disability for VA compensation purposes if it results in functional impairment 1. This overturned previous precedent that required an underlying pathology for pain to be considered a disability.
Effective Dates
Martinez v. McDonough (2023)
This case dealt with the denial of an earlier effective date for a total disability rating based on individual unemployability (TDIU) 2. It addressed issues around the validity of appeal withdrawals and the consideration of cognitive impairment in such decisions.
Rating Issues
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Tbird, -
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Are all military medical records on file at the VA?
RichardZ posted a topic in How to's on filing a Claim,
I met with a VSO today at my VA Hospital who was very knowledgeable and very helpful. We decided I should submit a few new claims which we did. He told me that he didn't need copies of my military records that showed my sick call notations related to any of the claims. He said that the VA now has entire military medical record on file and would find the record(s) in their own file. It seemed odd to me as my service dates back to 1981 and spans 34 years through my retirement in 2015. It sure seemed to make more sense for me to give him copies of my military medical record pages that document the injuries as I'd already had them with me. He didn't want my copies. Anyone have any information on this. Much thanks in advance.-
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RichardZ, -
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Caluza Triangle defines what is necessary for service connection
Tbird posted a record in VA Claims and Benefits Information,
Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL
This has to be MEDICALLY Documented in your records:
Current Diagnosis. (No diagnosis, no Service Connection.)
In-Service Event or Aggravation.
Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”-
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Tbird, -
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Post in ICD Codes and SCT CODES?WHAT THEY MEAN?
Timothy cawthorn posted an answer to a question,
Do the sct codes help or hurt my disability ratingPicked By
yellowrose, -
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Post in Chevron Deference overruled by Supreme Court
broncovet posted a post in a topic,
VA has gotten away with (mis) interpreting their ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.
They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.
This is not true,
Proof:
About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because when they cant work, they can not keep their home. I was one of those Veterans who they denied for a bogus reason: "Its been too long since military service". This is bogus because its not one of the criteria for service connection, but simply made up by VA. And, I was a homeless Vet, albeit a short time, mostly due to the kindness of strangers and friends.
Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly. The VA is broken.
A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals. I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision. All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did.
I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt". Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day? Va likes to blame the Veterans, not their system.Picked By
Lemuel, -
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Question
AchillesH
Evening,
First, thank you for reading this post. Being my first post I know its long, but thank you for reading and for all the amazing information on this site.
I served for 4 years in a Stryker Infantry Battalion as a 19 Kilo, with one deployment to Iraq. I was honorably discharged Feb 2012. Current I am receiving 50% total disability, but the current issue is with my Degenerative Disc Disease, which is rated at 10%. I am a 27 year old male, I stay and shape and I eat healthy. Since Janurary of this year I have been dealing with a herniated disc that has limited practically all of my functionality. I've only been able to see my VA primary care provider 4 times. I am currently undergoing a 3rd month of physical therapy and had an EMG test done. My primary care provider has only done 2 X-rays, and when I asked him for an MRI (which a nurse at the hospital told me to do) he said, "only if I am considering surgery." He then followed it with "this isn't the Department of Defense, can't give MRI's for everything."
Today, when I confronted my primary care provider about my degenerative disc disease, he reverted back to saying everyone has DDD, and that he has no idea why the VA is giving me compensation for it. He also through in, this is normal for someone my age. I then proceeded to explain why I am so worried. I am 27, can't apply for work when I can barely walk, beside the fact I havn't been able to bend over or reach in 7 months. He said not to worry about the income and that everything eventually finds its way. He then proceeded to tell me that we all die from one thing or another and that everything we do leads us more into the disease that will kill us. He then itterated that I was not going to die.
When I asked him if he thought this was service connected, he immediately said no. He began to explain about, yes in the military we go through some stuff, rucking and running, but it is no different from the wear and tear that civillians face.
He is now sending me back to the EMG specialist for I don't know what. He says she'll give me more answers, even though I've already seen her....and asked her these questions. We also don't have any concrete evidence that its a herniated disc because it didn't show on an X-Ray; although the physical therapists thinks it is a herniated disc. He said the meeting with the EMG doctor again might show that I have a tear in a nerve now.
I understand everyone has DDD, but what I find hard to believe is that everyone is incapacitated for 7+ months in their late 20's due to a herniated disc that just randomly pops out. I am not asking for a handout and I am not lazy. I am working on my second degree because thats all I can do at the moment. I just don't know what to do, especially when all three of these experts say they don't know why the VA is giving me a % for DDD and that I will continue to go through this the rest of my life, and that what I am going through now is not in any way connected to DDD.
Is he treating me like some drone who will believe whatever he says or am I overreacting?
Thank you for your time, service and any input you can offer.
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georgiapapa
Welcome. Just because you are now under VA healthcare and not under DOD healthcare does not mean they have the right to lower the standard of healthcare you are entitled to receive. Your PCP sounds
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